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Medicaid Prospective Payment System for Nursing Homes - Oppose the final model recommended by Navigant in the report to the Governor and Legislature, motivate LeadingAge Florida members to vigorously advocate against the implementation of the new payment plan, and present a fully developed alternative model incorporating the positive aspects of the Navigant plan without disrupting the current level of quality care provided.

Oppose the Office of Insurance Regulation’s proposed changes to chapter 651, F.S., until all stakeholders are involved in the process and have the opportunity to identify necessary changes and participate in the development of statutory language.

LeadingAge Florida’s Position on Legislation

Medicaid Prospective Payment System for Nursing Homes:
LeadingAge Florida opposes the Prospective Payment System model developed by the Agency for Health Care Administration, and has developed an alternative model for consideration that retains elements of the AHCA plan, while preserving quality nursing home care.

The 2016 Legislature appropriated $500,000 to the Agency for Health Care Administration (AHCA) to contract for the development of a prospective nursing home payment plan. AHCA requested this issue to reduce the administrative burden and to eliminate the large number of retroactive rate adjustments that occur under the current retrospective payment system.

The AHCA/Navigant proposal would shift $109 million from mostly high-quality nursing homes to mostly lower-quality nursing homes; it therefore threatens the quality of care that is currently delivered by Florida’s nursing homes and will devastate many of the state’s 5-star providers.

The Navigant prospective payment plan largely ignores historic trends and established business practices and increases payment to lower cost providers at the expense of higher cost, but generally higher quality nursing homes.

There is no requirement within the Navigant proposal that funding gained by poor quality nursing homes be used to improve performance or services to residents.

There are 143 nursing homes with 4 or 5 star ratings which will lose funding under the Navigant proposal, while 86 nursing homes with 1 or 2 star ratings will gain funding. In these cases, Medicaid funding is lost by nursing homes that are providing high quality care to residents; while nursing homes which have failed to do so, gain funding.

The Navigant plan results in extreme loses and gains: the 4 and 5 star nursing homes that lose reimbursement under the plan, lose $42 million; while the 1 and 2 star nursing homes that gain under the Navigant plan, gain $26 million.

The current proposals cannot help but:

reduce nursing homes quality of care,

impose extreme financial hardship on a large number of high quality homes, and

lead to loss of jobs in the nursing home field.

It is highly unlikely that all of those homes that gain additional dollars under the proposed plan will spend these funds to improve their resident care since some of them are already making a profit on Medicaid and have elected not to enhance care in their facilities. Improving care can cost more than the potential Medicaid payment increase.

LeadingAge Florida has developed an alternative plan that achieves the goals of simplicity, budget neutrality, and quality without the devastating effects of the AHCA plan. The alternative simply begins with current rates, and allocates the current quality component based on the actual quality performance of the nursing home.

Certificate of Need for Nursing Homes:

LeadingAge Florida supports the retention of a CON process for nursing home beds.

LeadingAge Florida supports amendments to HB 7 by Rep. Alex Miller and SB 676 by Sen. Bradley removing provisions in the bills that repeal the certificate of need requirement for nursing homes.

The CON process encourages efficient use of less restrictive long-term care options and, therefore, restrains long-term care cost increases for Medicaid as well as for all other payers.

Without a Certificate of Need process Florida would experience a significant growth in nursing home beds. This growth would outpace population growth and corresponding need for new beds.

Nursing homes are the most expensive component of the long-term care system and an uncontrolled growth in bed capacity would increase overall long-term care costs.

Florida already experiences staffing shortages. The addition of a large number of new nursing home beds would create competition for licensed nurses and certified nursing assistants with concomitant salary and benefit wars. Most new nursing homes would be constructed by large multi-facility, multi- state corporations that could offer higher rates and operate at a loss for a period of time. Their pay structure for direct care, as well as all other staff, could not be matched by most nonprofit and small for-profit nursing home operators.

Without some mechanism to control the growth of nursing home beds, a two-tiered system, one for private pay/Medicare and one for Medicaid would emerge.

As newly constructed facilities siphon off more profitable private pay and Medicare beneficiaries, quality of care would decline in older nursing homes. Financial challenges would escalate for highly respected nonprofit and small for-profit community nursing homes without the resources to renovate or replace older buildings or corporate resources to rely on.

Negative financial impact on the Medicaid budget would be immediate as increased direct care staff wages and benefits would create added pressure on AHCA and the Legislature to increase payment rates.

Non-profit and small for-profit nursing homes would be hurt the most by the elimination of the CON. As the research indicates, non-profit homes tend to be among the best in the state. In addition, many are pillars of the community with a long history of serving frail Floridians – some for more than 50 years.

Significant increase in the number of nursing homes would create additional workload and increase in licensure inspection staffing.

Modify criteria for OIR approval of change in general partner, specifically any change in general partner, regardless of the percent of financial interest in the facility (current law is 10%), would necessitate a notification and application to OIR for approval.

Clarify that information that by law must be disclosed to prospective residents about expansion plans and other activities should be available to the president or chair of the residents’ council.

Require disclosure of information about OIR findings, including outstanding deficiencies, to the president or chair of the residents’ council.

Require disclosure of information about a pending sale or change of ownership to the president or chair of the residents’ council.

LeadingAge Florida opposes the Office of Insurance Regulation’s proposed changes to chapter 651, F.S., until all stakeholders are involved in the process and have the opportunity to identify necessary changes and participate in the development of statutory language.

LeadingAge Florida and its 56 CCRC members support thoughtful regulatory reform that protects Florida’s seniors and their investments in senior care.

The lengthy bill, developed by the Office of Insurance Regulation (OIR) without input from stakeholders, makes major revisions to almost every section of Ch. 651, F.S., (the law governing the regulation of continuing care retirement communities) and creates another eight sections of law.

Continuing care retirement communities are not a typical insurance product. That is why the Florida Legislature, like most other states, created a separate chapter of law to regulate them.

All the information OIR needs to monitor the financial condition of continuing care retirement communities and detect financial weaknesses is available in the annual, quarterly and monthly reports and data calls that providers are required to file.

With the exception of three recent bankruptcies (one related to a CCRC that opened during the recession and was affected by the depressed housing market and another that blatantly violated the law), there have been no defaults in Florida over the past 25 years. OIR failed to use information readily available through various required reports to detect financial weaknesses for the two CCRCs before they became a major concern.

The bill creates another substantial financial reserve (in addition to the minimum liquid reserve) that OIR has not modeled to determine its effect on individual providers and resident fees. Providers will be required to comply immediately without a phase-in. Failure to meet the requirement could result in the suspension or revocation of the certificate of authority to operate and sell contracts.

The bill imposes significant financial burdens and risks on CCRC residents; there is no dispute on this point – the Office of Insurance Regulation has testified that its analysis shows an increase in costs to residents as a result of the bill. In one community, just one provision in the bill would result in a $40,000 assessment per resident.

Ultimately, the bill threatens and potentially limits an important retirement and care option for seniors in Florida, even as the 70-79 year-old age group is the fastest growing demographic in our state.

The bill will not only chill future development of continuing care retirement communities in Florida, it could create unintended financial problems for successful communities that have been in existence for 20 to 65 years.

Use Housing Trust Funds for their Intended Purpose:

As a member of the Florida Sadowski Housing Coalition, LeadingAge Florida supports the appropriation of all the state and local housing trust fund money for affordable housing.

Funding to construct or preserve affordable housing in Florida comes from documentary stamp tax paid on all real estate transactions, which was increased in 1992. Those monies were set aside as state and local housing trust funds.

70% of the monies go to the Local Government Housing Trust Fund for the State Housing Initiatives Partnership (SHIP) program, which funds housing programs in all 67 counties and larger cities.

30% of the monies go to the State Housing Trust Fund for Florida Housing Finance Corporation programs, such as the State Apartment Incentive Loan (SAIL) program.

By allocating the full appropriation of the estimated $292.4 million in the state and local housing trust funds in Fiscal Year 2017-18 into Florida's housing programs 28,300 jobs will be created and $3.57 BILLION in positive economic impact in Florida will result.

The Governor’s Recommended FY 2017-18 Budget would shift almost 77% of the $292.4 million earmarked for low-income housing to other state priorities ($224 million from state and local housing trust funds).

LeadingAge Florida supports an amendment to SB 854 by Sen. Jeff Brandes and HB 1013 by Rep. Newt Newton adding a representative of LeadingAge Florida to the affordable housing task force created in the bill and a requirement for a task force recommendation on affordable senior housing.

Investment in housing plus services models helps support aging in place initiatives by preventing admission to higher cost care centers such as nursing homes and assisted living. Participation in a task force created by SB 854 and HB 1013, if enacted, will give LeadingAge Florida a voice in developing recommendations for addressing the affordable housing needs of Florida’s seniors.

January 7, 2016

2016 Pre-Legislative Session Report

Interim Legislative Committee meetings have concluded and the 2016 Regular Legislative Session begins Tuesday, January 12th and is scheduled to run through Friday, March 11th.

In 2014, the Legislature approved legislation changing the start date of the 2016 Session from early March to January. Previously, the Legislature met in January only when drawing Congressional and Legislative districts every ten years.

To date, 668 bills have been filed in the Senate and 625 in the House for a total of 1,293. Last year, a total of 1,754 bills were filed—881 in the Senate and 873 in the House. The bill filing deadline is noon on the first day of Session, January 12th, so we can expect to see bills filed until that time.

For 2016, we will be assisted in our advocacy efforts by our new contracted lobbying firm, Greenberg Traurig, with Hayden Dempsey and Leslie Dughi as our lead lobbyists. Hayden Dempsey is the Chair of the firm's Government Law & Policy Practice for the state of Florida. Hayden has extensive governmental experience, having served in four governors’ administrations, and lobbies on behalf of numerous private and public clients before both the Legislature and state agencies and represents clients in Medicaid and health policy matters, procurement disputes, transportation and infrastructure issues, health care regulatory matters, and election matters. He also specializes in the lobbying of insurance and other regulatory issues before the Office of Insurance Regulation and the Florida Legislature.

Leslie Dughi's state practice spans more than 20 years and includes all areas of the executive and legislative branches of government. Over the years, Leslie has represented health care entities and providers, including statewide associations, and served as the Director of Government Affairs for the Florida Chamber of Commerce, where she developed strategic relationships and led many legislative and grassroots initiatives important to the business community. Leslie has particular experience in the lobbying of health care and health insurance matters and other regulatory issues before the various state agencies and the Florida Legislature. Leslie has considerable experience in political communications, serving as the Political Director for Associated Industries, Florida’s largest statewide business association. Throughout her career she has coordinated numerous grassroots advocacy campaigns for business entities and statewide trade associations.

Hayden and Leslie will be actively participating in Advocacy in Action on February 9 and 10, 2016, and on our weekly legislative recap calls, which will be held every Friday at 10 a.m., beginning Friday, January 15th. Information on how to participate in the weekly calls will be published in our LeadingLink newsletter, and distributed through member alerts.

Greenberg Traurig has shared with us their Florida 2016 Political Overview and Legislative Forecast. This document provides a summary of election activities, and highlights of Governor Scott’s Recommended Budget for Fiscal Year 2016-17. Priorities of the House and Senate leadership and highlights of key legislative issues are also included.

In addition to our contract lobbyists, Hayden and Leslie, and Beth Vecchioli of Holland & Knight, our public policy team, consisting of Steve Bahmer, President/CEO, Susan Langston, Vice President of Advocacy, Mary Ellen Early, Public Policy Liaison, and Erwin Bodo, Reimbursement Specialist, will continue to work hard to advocate on your behalf. Our most important resource in effective advocacy efforts, however, is you, our members, connecting with your legislators at the local level.

LeadingAge Florida Advocacy Activities

Other legislative proposals affecting you, our members, are being identified, tracked and monitored for any amendments impacting your residents or your community. Many of these proposals are summarized in this document under the Bills of Interest to LeadingAge Florida Members section. Other bills being tracked and monitored for amendments are included in the LeadingAge Florida – Legislative Tracking Report. This tracking report will be updated and distributed weekly along with a recap of legislative activities occurring each week on our priority legislative proposals and other bills of interest.

LeadingAge Florida Priorities

Several initiatives relating to LeadingAge Florida’s priorities for 2016 are taking place in Tallahassee. The 2016 Public Policy Priorities are:

Preserve the Certificate of Need for Nursing Homes

Support the Governor’s Legislative Budget Recommendation for $500,000 in Funding for AHCA to Contract with an Independent Consultant to Develop a Plan, in Concert with Interested Stakeholders including LeadingAge Florida, to Convert Medicaid Payments from a Cost-based Reimbursement Methodology to a Prospective Payment or Similar System

Modify the Gold Seal Nursing Home Financial Criteria for Nursing Homes that are Part of Continuing Care Retirement Communities

Update on LeadingAge Florida 2016 Legislative Priorities

Modify the Gold Seal Nursing Home Financial Criteria for Nursing Homes that are Part of Continuing Care Retirement Communities

and , filed on behalf of LeadingAge Florida, allow a non-accredited Continuing Care Retirement Community (CCRC) applying for the Gold Seal nursing home designation to submit financial statements prepared by an independent CPA for the community in its entirety as proof of compliance with the financial criteria established by AHCA. A nursing home that is part of a CCRC accredited by a national accreditation organization and meets the minimum liquid reserve requirements in Ch. 651 would still be deemed to meet the financial criteria for the Gold Seal designation.
This legislative language was proposed by the 2014-15 LeadingAge Florida/FLiCRA Ch. 651 Task Force to address declining interest in accreditation because of the cost and change in focus. At last count, only 6 of the state’s 71 licensed CCRCs were accredited, while 7 of 26 Gold Seal nursing homes are part of a CCRC. The bill would eliminate the cost of providing three years of separate financial statements prepared by a CPA for the nursing home if the CCRC is not accredited and wishes to pursue the Gold Seal designation.
HB 127 and SB 542 have both been heard in committee and amended to allow a nursing home which is part of a corporate entity operating nursing homes, assisted living facilities, or independent living facilities to satisfy the financial soundness and stability requirement of the Gold Seal Program by submitting a consolidated corporate financial statement to AHCA and demonstrating the corporate entity, in its entirety, meets the financial standards established by AHCA. The Florida Health Care Association requested this amendatory language.
Each bill has one more committee stop before heading to the Floor for consideration by the full House or Senate. There has been no opposition to either bill in committee. During the House Health Innovation Subcommittee meeting, Rep. Hill (R-Pensacola) suggested to Rep. Cummings a portion of the $5.5 million AHCA receives in total fines from licensed facilities be used as an incentive for nursing homes to seek the Gold Seal designation. In other words, reward nursing homes or front line workers using revenues from those fines to encourage more facilities to try to attain this designation.

Florida is the only state in the nation that does not allow ARNPs to prescribe controlled substances, yet these professionals play an increasingly important role in our health care system, particularly in long-term care settings where physicians are not on site to oversee pain management. Several bills have been filed expanding the scope of authority for ARNPs.
authorizes an advanced registered nurse practitioner to order any medication for administration to a patient in a hospital, ambulatory surgical center, or mobile surgical facility within the framework of an established protocol. The bill provides express authority in Chapter 893, Florida Statutes, the Florida Comprehensive Drug Abuse Prevention and Control Act, for a supervisory physician to authorize a physician assistant or an advanced registered nurse practitioner to order controlled substances for administration to a patient in a hospital, ambulatory surgical center, or mobile surgical facility. SB 152 has passed two of its three committees of reference and is now in the Senate Appropriations Committee.
LeadingAge Florida asked Sen. Grimsley to consider an amendment expanding the scope of this bill to include nursing homes. Rather than amending SB 152, Sen. Grimsley filed our proposed amendment as a stand-alone bill, SB 946. has three committees of reference and has not yet been heard in committee.
We have been advised the House companion to SB 152 will be filed by Rep. Plasencia (R-Orlando). The House Bill Drafting deadline passed before we were able to get the language expanding the scope of the bill to include nursing homes into bill drafting; however, both Rep. Plasencia and Rep. Pigman (R-Sebring) have expressed a willingness to help us get this language amended onto another bill.
by Sen. Grimsley and companion by Rep. Pigman relating to Health Care authorize ARNPs and physician assistants to prescribe controlled substances under the supervision of a physician in any setting. As Rep. Pigman pointed out in presenting the bill to the Health Quality Subcommittee, Florida is the only state that does not allow ARNPs and physician assistants to prescribe under a physician’s guidance. The bill passed the Subcommittee and now is in the Health Care Appropriations Subcommittee. The Senate companion has not yet been heard in committee. This legislation would help LeadingAge Florida members that use ARNPs or PAs and is preferable to the other bills filed because it applies to all health care settings.

Preserve the Certificate of Need for Nursing Homes
Over the past several years, the Florida Legislature significantly reduced the number of services and facility types subjected to Certificate of Need (CON) review. LeadingAge Florida supports the retention of a CON process for nursing home beds. The CON process encourages efficient use of less restrictive long-term care options and, therefore, restrains long-term care cost increases for Medicaid as well as for all other payers.

HB 437 by Rep. Sprowls (R-Clearwater) deletes the provisions relating to certificates of need required for new, expanded, or modified hospital construction. A Senate companion measure has not yet been filed. The bill passed its first committee of reference, House Select Committee on Affordable Healthcare Access, and has two more committees of reference.

Recently, Senate President Andy Gardiner (R-Orlando) said nursing homes and other health-care providers should be part of the debate if lawmakers consider eliminating the "certificate of need" regulatory process for hospitals. "If CON is so bad, it must be bad for everybody,'' Gardiner said in an interview with The News Service of Florida. According to the News Service of Florida, Gov. Rick Scott and House Republican leaders are seeking a series of regulatory changes in the health-care system and want to eliminate certificates of need for hospitals --- but have not addressed the issue for other providers. Adding industries such as nursing homes to the debate could make it harder politically to pass an elimination of certificates of need.

LeadingAge Florida President/CEO Steve Bahmer presented a statement published by Politico which stated, in part, “LeadingAge Florida… also has reservations about eliminating certificate of need for nursing homes. In an email to POLITICO Florida, the group's President and CEO Steve Bahmer said the regulatory system helps control Medicaid long-term care costs by ‘encouraging efficient use of less restrictive long term care options.’”

LeadingAge Florida’s advocacy team is on top of this issue and will keep our members posted on any efforts to eliminate CON requirements for nursing homes.

Support the Governor’s Legislative Budget Recommendation for $500,000 in funding for AHCA to contract with an independent consultant to develop a plan, in concert with interested stakeholders including LeadingAge Florida, to convert Medicaid payments from a cost-based reimbursement methodology to a prospective payment or similar system.

Governor Scott’s FY 2016-17 Recommended Budget includes a $500,000 appropriation to the Agency for Health Care Administration (AHCA) to contract with an independent consultant to develop a plan to convert Medicaid payments for nursing home services from a cost-based reimbursement methodology to a prospective payment system. LeadingAge Florida supports the Governor’s budget recommendation provided that the study is done in concert with interested stakeholders including LeadingAge Florida.
The current Florida Medicaid Long Term Care Reimbursement Plan was developed over 30 year ago with input from stakeholders. The plan has been tweaked periodically, but it has fundamentally served Floridians well by encouraging providers to spend adequate money on care rather than profit, subject to cost limits and caps.
During the 2015 Legislative Session, the House proposed a study to transition nursing home reimbursement from fee-for-service to a prospective reimbursement plan. The House proposal called for a very short study time-frame and no formal input from stakeholders. It is important lawmakers call for a longer study period so AHCA has sufficient time to collaborate with providers and other stakeholders in the development of a prospective payment system which is appropriate for Florida and does not undermine the quality of nursing home care.
LeadingAge Florida continues to analyze a “new Medicaid Reimbursement Plan” being circulated by the Florida Health Care Association/Our Florida Promise that would result in substantial losses by non-profit and small independent nursing homes and significant gains by for-profit multi-facility providers. LeadingAge Florida members have been provided background information on the proposed plan, an analysis of the plan and our strategy for addressing this effort.
We want to assure you that we are on top of this issue and will be working with all interested parties to develop and define a fair and equitable reimbursement system.

Increase Funding for Affordable Housing as Proposed by the Sadowski Housing Coalition

Funding to construct or preserve affordable housing in Florida comes from documentary stamp tax paid on all real estate transactions, which was increased in 1992. Those monies were set aside as state and local housing trust funds.
The Florida Housing Finance Corporation (FHFC) submitted a funding request to the Governor’s Office of Policy and Budget which requested full funding of $323.96 million ($226.5 million for SHIP and $97.4 Million for FHFC Programs, including SAIL).
The Governor’s Recommended FY 2016-17 Budget provides a total of $131.4 million for housing ($34 million for SHIP and $97.4 million for SAIL).
As the House and Senate work through the appropriations process during the 2016 Legislative Session, the Sadowski Housing Coalition, of which LeadingAge Florida is a member, will again be advocating for the appropriation of all the state and local housing trust fund money; the money collected from the portion of the doc stamp dedicated for affordable housing.

Uniform Fire Safety Provisions for Assisted Living Facilities

and require the State Fire Marshal to adopt uniform fire safety standards for ALFs and provide fire safety requirements be based on the current editions of the National Fire Protection Association, Life Safety Code, NFPA 101 and 101A. Evacuation capability determination and fire safety requirements currently in law are deleted. The NFPA documents are revised on a three year cycle to incorporate new technologies and lessons learned from actual fire experiences. This change will allow for the adoption of the current edition of the NFPA Life Safety Code for ALFs. Neither bill has been referred to committee.

Bills of Interest to LeadingAge Florida Members

CS/HB 313 by Rep. Pilon (R-Sarasota) provides for additional reporting exemptions from the Prescription Drug Monitoring Program (PDMP) for a rehabilitative hospital, an assisted living facility or a nursing home dispensing a controlled substance, as needed, to a patient as ordered by the patient’s treating physician. This bill would benefit LeadingAge Florida members.

Legislation passed in 2009 established the Prescription Drug Monitoring Program (PDMP) within the Department of Health. The PDMP uses a comprehensive electronic system/database to monitor the prescribing and dispensing of certain controlled substances. Dispensers of controlled substances listed in Schedule II, III, or IV must report specified information to the PDMP database, including the name of the prescriber, the date the prescription was filled and dispensed, and the name, address, and date of birth of the person to whom the controlled substance is dispensed. Dispensers must report the dispensing of a specified controlled substance to the PDMP database within seven days of dispensing the controlled substance. Health care practitioners are exempt from the PDMP reporting requirements in certain instances.
CS/HB 313 has had one committee hearing and has one more committee of reference, House Health & Human Services Committee. The Senate companion, SB 964 by Sen. Grimsley has been filed and referred to three committees.

Property Prepared for Tax Exempt Use

HB 301 by Rep. Burton (R-Lakeland) consolidates provisions relating to tax exemptions on property owned by certain tax-exempt organizations and expands the ad valorem tax exemption for an exempt organization that is taking affirmative steps to prepare property to be used for an exempt purpose. Current law grants this treatment to educational institutions, religious organizations, and 501(c)(3) organizations that provide affordable housing. The bill expands the exemption to all property being prepared for an educational, literary, scientific, religious or charitable purpose.

This legislation was filed and considered during the 2015 Legislative Session. As filed in 2015, in consolidating the existing provisions regarding affirmative steps provisions into a single section of law and extending the affirmative steps to all property owned by an exempt entity that has taken affirmative steps to prepare the property for an exempt educational, literary, scientific, religious or charitable use, the bills removed the reference to an organization taking affirmative steps to prepare the property to to qualified persons or families. Removing this language created a concern that some property appraisers may interpret the new language to mean that nonprofit developers of affordable housing are no longer eligible for the exemption.
In 2015, LeadingAge Florida succeeded in getting the House bill amended to clarify that providing affordable housing is considered a charitable use, and in having the Senate Bill Analysis state that the exemption for property purchased by a nonprofit organization for affordable housing would not be affected by the change in statutory language.
HB 301 includes the language amended onto last session’s House Bill defining “charitable use” to specifically include providing affordable housing; however, the Senate companion, SB 842 by Sen. Hays (R-Umatilla), as filed, does not include this provision. Neither bill has been heard in committee.

Involuntary Examinations under the Baker Act

HB 325 by Rep. Campbell (D-Miami Shores) and SB 572 by Sen. Altman (R-Cape Canaveral) authorize physician assistants and ARNPs to initiate involuntary examinations under the Baker Act of persons believed to have mental illnesses. HB 325 has been approved by two House Committees and has one more committee of reference; SB 572 has been favorably passed out of one committee and has two more committees of reference in the Senate.

Protection of Religious Freedom

HB 401 by Rep. Gonzalez (R-Venice) provides immunity from liability for religious institutions, health care providers, including nursing homes, assisted living facilities and hospices, and other entities for refusing to perform certain actions, such as a medical treatment or procedure that would be contrary to religious or moral convictions or policies. The bill has three committees of reference and has not yet been heard in committee. To date, no Senate companion has been filed.

Physician Orders for Life-sustaining Treatment (POLST)

SB 664 by Sen. Brandes (R-St. Petersburg) directs the Department of Health to develop and adopt a POLST form by rule, authorizes specific personnel to withhold CPR pursuant to a DNRO or a POLST form which contains an order not to resuscitate, and provides immunity from civil and criminal liability to such personnel, facility staff and facilities for withholding or withdrawing CPR. The Agency for Health Care Administration (AHCA) is directed to act as a clearinghouse of information on compassionate and palliative care plans and develop and implement a database for this information. AHCA is also directed to consult with compassionate and palliative care providers, health care facilities and residents in the development and implementation of the database.

Sen. Brandes has filed , a bill linked to SB 664, relating to Public Records/Clearinghouse for Compassionate and Palliative Care Plans. This bill creates an exemption from public records for identifying information in compassionate and palliative care plans filed with the clearinghouse at the AHCA. In Florida, legislation relating to privacy of records and providing an exemption from public records requirements must be filed separately.
During the 2015 Legislative Session, Sen. Brandes amended language very similar to the provisions of SB 664 onto a bill he sponsored creating the “Florida Right to Try Act”. The language was removed in the next committee of reference and the bill passed the Legislature without the POLST language. The POLST provisions were never introduced in the House.